Montana Code 53-1-414. Automatic assignment of resident’s resources from third party
53-1-414. Automatic assignment of resident‘s resources from third party. (1) Upon the provision of care to a resident, the resident is considered to have assigned to the department all third-party payments, benefits, and resources applicable to the resident’s care.
Terms Used In Montana Code 53-1-414
- Care: means the care, treatment, support, maintenance, and other services rendered by the department to a resident. See Montana Code 53-1-401
- Cost of care: means the applicable all-inclusive rate charges or per diem charges and ancillary charges for a resident's care that are determined as provided in this part. See Montana Code 53-1-401
- Department: means the department of public health and human services provided for in 2-15-2201. See Montana Code 53-1-401
- Financially responsible person: means a spouse of a resident, the natural or adoptive parents of a resident under 18 years of age, or a guardian or conservator to the extent of the guardian's or conservator's responsibility for the financial affairs of the person who is a resident under applicable Montana law establishing the duties and limitations of guardianships or conservatorships. See Montana Code 53-1-401
- Obligation: An order placed, contract awarded, service received, or similar transaction during a given period that will require payments during the same or a future period.
- Person: includes a corporation or other entity as well as a natural person. See Montana Code 1-1-201
- Resident: means any person who is receiving care from or who is a resident of an institution listed in 53-1-402. See Montana Code 53-1-401
- Third party: means any third-party individual or entity that is or may be liable to pay all or part of the charges for a resident's cost of care, including but not limited to applicable medicare, medicaid, and personal insurance or other similar health care benefits. See Montana Code 53-1-401
(2)The department is entitled to all third-party payments, benefits, and resources assigned under this section upon demand and the submission of supporting documentation from the department to the third party. The department is entitled to collect from the third party the full amount payable by the third party, up to the resident’s full cost of care. Collection is not limited to the amount that the resident or financially responsible person has been determined able to pay under 53-1-405.
(3)The fact that a managed care organization contracting with the department to administer a mental health managed care program is or may be liable to pay or has paid an amount to an institution with respect to the resident does not reduce or otherwise affect the third party’s obligation to pay for the cost of care as provided in this part.
(4)The department may assign its rights under this section to a managed care organization contracting with the department to administer a mental health managed care program.
(5)If a third party that has been notified of the department’s or managed care organization’s claim under this section pays benefits, resources, or other amounts to a resident, financially responsible person, or another person or entity without satisfying the department’s or managed care organization’s claim, the third party is liable to the department or to the managed care organization for the amount that the department or managed care organization was entitled to receive under this part.